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Endoscopic transventricular biopsy in brainstem diffuse midline glioma: how I do it
Emanuele La Corte1,2, Micol Babini3, Giada Bortoluzzi3,4
1Pediatric Neurosurgery Unit, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy. emanuele.lacorte2@unibo.it.
Acta Neurochirurgica
|December 9, 2022
Summary
Endoscopic biopsy offers a safe method for diagnosing pediatric brainstem diffuse midline gliomas. This approach aids in molecular diagnosis and managing hydrocephalus, improving patient outcomes.
Area of Science:
- Pediatric neuro-oncology
- Minimally invasive neurosurgery
Background:
- Brainstem diffuse midline gliomas are rare, infiltrative pediatric tumors with poor prognoses.
- Surgical biopsy is crucial for diagnosis and identifying molecular markers for targeted therapies.
Purpose of the Study:
- To describe the technique of endoscopic trans-ventricular biopsy for brainstem diffuse midline gliomas.
- To highlight the procedure's utility in managing associated ventriculomegaly.
Main Methods:
- Endoscopic trans-ventricular biopsy of brainstem diffuse midline glioma.
- Description of surgical anatomy and illustrative video provided.
- Combined endoscopic third ventriculostomy and punch biopsy.
Main Results:
- The combined procedure is feasible and low-risk.
- Simultaneous treatment of hydrocephalus and molecular diagnosis is achieved.
Conclusions:
- Endoscopic biopsy is a viable approach for pediatric brainstem diffuse midline gliomas.
- This technique facilitates molecular diagnosis for future targeted treatments.
- It effectively manages associated hydrocephalus concurrently.
